• All threads and posts regarding Coronavirus COVID-19 can be found in our area specifically for Coronavirus COVID-19 discussion.

    You can directly access this area >here<.

Leaky Legs

Scarlet Lady

Registered User
Apr 6, 2021
139
0
Apologies if I haven’t put this in the right place, but I’d forgotten how to open a new thread! My issue is that my aunt with AD was finally admitted to hospital yesterday. The problem was severe oedema, resulting in badly weeping legs caused by a massive decline in heart failure. The doctors have ignored it for ages, but finally two lovely young Community Practitioners took everything on board and she was admitted as an emergency case.

Nine hours later she still wasn’t on a ward, so I was forced to go home. This morning, established the ward she was on but couldn’t speak to anyone. Eventually was rung by a physio, who, despite being given up to date contact details numerous times still managed to contact the wrong person. However, got sorted and she was very helpful. The upshot was that she was being treated and she probably would need to be moved from emergency care while her ongoing care needs were assessed. I understood that everything would need to be reviewed and she said there would be a planning review later in the day.

A couple of hours later, the hospital social worker rang and said that all plans had been changed. She would not be moved to observational care while treatment was ongoing. They intended to simply discharge her and wanted me to arrange a ‘facility’ for her to go to. She cannot stand up unaided, her legs are still weeping badly and nothing has been done about the heart problems. I said that I had no objections to a ‘best interests’ discussion about what should happen next, but that I was adamantly opposed to a discharge without that happening. She said she would pass the info on.

A couple of hours later, I got a call from a very patronising young consultant (only know ‘young’ because I googled him) who mansplained that I needed to understand that people get admitted to hospital to be assessed and possibly given emergency treatment, but after that, they do not need to be in hospital even if they are no better than they went in. I said very patiently that after 67 years on the planet (way more than he’s got), I thought I understood how hospitals worked, but I couldn’t accept that after fighting so long for any sort of medical help for my aunt, they expected me to find a care facility to discharge her to with no notice whatsoever. He said he couldn’t understand my attitude, even though this was 3.30 in the afternoon and they wanted to discharge her immediately. I’m afraid that after two days of stress and phone calls, I totally lost my temper. I told him exactly what I thought of him and his Hippocratic Oath and said that I was relinquishing my responsibility and support for my aunt forthwith. She will now become the responsibility of Social Services. Then I hung up on him.

It breaks my heart to give up on J, something I said I’d never do. I’m the only person she’s got. But I can’t do this anymore. I simply cannot fight a system thst doesn’t care, that has no humanity and isn’t willing even to work with families. The NHS doesn’t give a **** about anybody. For the sake of my own health, I need to step aside. This has never really been my responsibility, now I need to let it go.

Sorry for the rant. I know others have experienced dreadful treatment from medical services, so I shouldn’t be surprised. But I was so pleased that finally she was getting some much needed attention. I’m devastated it’s ended like this.
 

marionq

Registered User
Apr 24, 2013
6,451
0
Scotland
@Scarlet Lady I have total sympathy with your situation. The system just isn’t geared to deal with elderly people who have neither spouse nor children. We used to talk about teachers being in loco parentis but I think we need a similar approach for health care so that a person on their own gets special protective care. They are entirely reliant on other relatives, friends or neighbours stepping up without considering the age or health of those people. If you have read some of my posts you’ll see I was the default carer for my sister in law but luckier in that I did manage to get good care for her eventually but it has taken its toll on me.

I hope things work out and I for one know what a strain this will be for you.
 

Sarasa

Volunteer Host
Apr 13, 2018
4,181
0
@Scarlet Lady, sorry I haven't got anything useful to say, but I couldn't pass by without saying I'm sorry that you had to refuse to continue to care for your aunt to get her the care she needs. It really doesn't sound in her best interests to have sent her home, and I don't think there was anything else you could do.
I'm sure others that have had similar experiences will be along shortly with some suggestions as to what you could do next.
 

Jaded'n'faded

Registered User
Jan 23, 2019
2,421
0
High Peak
I wonder if the young consultant and hospital social worker have instantly found a 'facility' for your aunt as they expected you to? Somehow I doubt it.

It's ridiculous the way they make impossible demands and heap the guilt on people - like you - who are simply trying to help. I'm sorry for how this has turned out but glad that you told the consultant what you thought of him. Your aunt needs and deserves hospital care for her heart/legs.
 

Bun

Registered User
Oct 2, 2021
57
0
@ Scarlet Lady. Sorry about your Aunt,and the stress it has coursed u. I wanted my husband moved from the care home he is in, to one closer to me. Had phone call from a Dr.... He said, he would not sign my husband out, he was staying were he is, he wouldn't reconise me or know me. I reported this Dr.
 

Scarlet Lady

Registered User
Apr 6, 2021
139
0
Thank you for all your responses, everyone. It’s much appreciated. I’m waiting to see what happens today. As @Jaded'n'faded said, I doubt the hospital social worker will have been able to find a ‘facility’ last night any more than I could.
 

Violet Jane

Registered User
Aug 23, 2021
585
0
I keep banging on about this subject to anyone who will listen. An increasing number of people do not have children (nearly a quarter of women born in the 1970s, and the figure for men is thought to be similar) and people who do have children generally have one of two. As more young people enter higher education more younger people leave their home towns to go to university or to take up jobs after university. The upshot is that there are fewer younger people to care for elderly relatives. The reality is that a nephew or niece or cousin is unlikely to do the things that a child would do and this is even less likely if the younger relative has their own parents or in-laws to care for. S/he may be working or looking after grandchildren. If s/he is older s/he may have his/her own health problems or be caring for a spouse. There are only so many elderly people that a younger person can support.

In Scarlet Lady's case, I think that it should have been a social worker who had the conversation about discharge rather than a doctor. A social worker has knowledge of local homes and could have suggested ones for Scarlet Lady to look at. If discharge to assess is thought to be appropriate then the social worker could arrange this.

As someone said above, it will be interesting to see how long it takes for SS for find a place for the aunt. It will also be interesting to see whether a social worker rings Scarlet Lady and adopts a more emollient tone than the doctor's. I support an elderly friend and once threatened to withdraw all support unless she was reassessed. She had had numerous falls but the hospital wanted to send her home with the same care package. I said that the care package was underpinned by my support and would fall apart if I withdrew support. The social worker did reassess her and said that 24 hour care would be a good option but did not actually advise that it was necessary. This was enough for us to start the ball rolling on live-in care as we did not have a PoA for health and welfare, only for property and financial affairs.

My elderly friend also has weeping legs which become ulcerated and infected from time to time even with visits from district nurses. She has a diagnosis of Heart Failure, Lymphoedema and something else. They are chronic problems which improve for a bit and then get worse again. I have noticed that in the care home (where she is staying temporarily whilst we are arranging live-in care) her legs seem to be less swollen and the dressings are less stained. Whether that is down to better care of her legs, or her sleeping in her bed rather than falling asleep in her armchair, or both, I do not know.
 

Scarlet Lady

Registered User
Apr 6, 2021
139
0
You are absolutely right in what you say, @Violet Jane. It actually was the SW who rang initially to say that what I’d been told was going to happen earlier in the day had been changed. She suggested that it was the doctors who had decided J didn’t need to be in hospital and wanted to discharge her yesterday afternoon. She asked me if I could find a care facility straight away. I said absolutely not and that was a totally unreasonable request. She agreed with me and intimated that she wasn’t happy with the decision the hospital had made. I also pointed out that J had not been fully assessed because there hadn’t been time and it seemed irresponsible to discharge her when she was in reality no better than she was when she’d been admitted.

She said she’d pass this info to the doctors, although I did get the impression she didn’t want to take responsibility for anything. I then got the call from the idiot consultant who couldn’t understand why I wasn’t deliriously happy with all this. I fully accept that J couldn’t stay where she is, because that hospital is really there for emergency and specialist care. I was happy with the initial idea that she would be transferred to another local hospital where she could continue to be cared for over a few days while her needs were properly assessed and we could have a ‘best interests’ discussions over her ongoing care. I was so incensed because none of that was going to happen. They basically just wanted to kick her out of the door and expected me to take full responsibility for whatever was going to happen next.

Footnote: I’ve just had a call from my Admiral Nurse who is as appalled as I am. She’s offered to see what she can do to help, so that’s a bit of good news, at least.
 

Sarasa

Volunteer Host
Apr 13, 2018
4,181
0
I do hope the Admiral Nurse can find out what is happening. Is it worth contacting the PALs department at the hospital to see if there is anything they can do.
I imagine the consultant was just focused on getting a bed rather than the practicalities of what would actually happen to your aunt.
 

lollyc

Registered User
Sep 9, 2020
673
0
I keep banging on about this subject to anyone who will listen. An increasing number of people do not have children (nearly a quarter of women born in the 1970s, and the figure for men is thought to be similar) and people who do have children generally have one of two. As more young people enter higher education more younger people leave their home towns to go to university or to take up jobs after university. The upshot is that there are fewer younger people to care for elderly relatives. The reality is that a nephew or niece or cousin is unlikely to do the things that a child would do and this is even less likely if the younger relative has their own parents or in-laws to care for. S/he may be working or looking after grandchildren. If s/he is older s/he may have his/her own health problems or be caring for a spouse. There are only so many elderly people that a younger person can support.

In Scarlet Lady's case, I think that it should have been a social worker who had the conversation about discharge rather than a doctor. A social worker has knowledge of local homes and could have suggested ones for Scarlet Lady to look at. If discharge to assess is thought to be appropriate then the social worker could arrange this.

As someone said above, it will be interesting to see how long it takes for SS for find a place for the aunt. It will also be interesting to see whether a social worker rings Scarlet Lady and adopts a more emollient tone than the doctor's. I support an elderly friend and once threatened to withdraw all support unless she was reassessed. She had had numerous falls but the hospital wanted to send her home with the same care package. I said that the care package was underpinned by my support and would fall apart if I withdrew support. The social worker did reassess her and said that 24 hour care would be a good option but did not actually advise that it was necessary. This was enough for us to start the ball rolling on live-in care as we did not have a PoA for health and welfare, only for property and financial affairs.

My elderly friend also has weeping legs which become ulcerated and infected from time to time even with visits from district nurses. She has a diagnosis of Heart Failure, Lymphoedema and something else. They are chronic problems which improve for a bit and then get worse again. I have noticed that in the care home (where she is staying temporarily whilst we are arranging live-in care) her legs seem to be less swollen and the dressings are less stained. Whether that is down to better care of her legs, or her sleeping in her bed rather than falling asleep in her armchair, or both, I do not know.
I am one of those people who doesn't have children. I don't have a partner, and don't have nephews / nieces / cousins. My only sibling is older than me. I dread the future, with no-one to fight my corner - it's bad enough when you do have someone looking out for you.
In my experience of hospital discharges, the staff are only interested in getting the patient off their ward. They really couldn't care less what happens to them afterwards.
Back in the day my mother worked at our local cottage hospital. Two wards, mostly filled with elderly patients recovering from admission at the general hospital, but not fit enough to go home. The staff were permanent (no agency) and got to know the patients well. Even the cleaning staff would have a chat with, or make a cup of tea for, the inmates. Somehow in the intervening years, the concept of caring seems to have been lost.
 

Banjomansmate

Registered User
Jan 13, 2019
3,398
0
Dorset
Cottage hospitals are being closed down, meaning there is nowhere for older people needing time for assessment/recovery to go to.
 

Violet Jane

Registered User
Aug 23, 2021
585
0
Yes, most of the intermediate / convalescent facilities seem to have been closed down and have been replaced by a package of care for a few weeks called something like Reablement or Rapid Response. There may have been good reasons for this; perhaps people became institutionalised and lost the skills they had whilst they were in these facilities. It may also have been connected with the drive to keep people at home for as long as possible.

I think that there is a real problem with people leaving hospital frailer than they came in, with infections which are still being treated or not full eradicated and reduced mobility because they have been sitting in bed or in a chair for days or weeks. These people need physiotherapy otherwise they will have a fall and be brought into hospital again within a few days of being discharged. What support people will get at home after discharge seems to be quite random. My elderly friend had about a month’s physiotherapy after one discharge but didn’t have any after the others. Mind you, the last few weeks before she went to the care home there wasn’t time to arrange any because she was admitted 4 times within the space of about 6 weeks and actually only spent 20 full days at home, spread between the admissions, in 67 days.
 

Scarlet Lady

Registered User
Apr 6, 2021
139
0
Just to provide an update: my aunt will be moved to a local care home for respite and assessment. It was supposed to happen yesterday, but they couldn’t find anywhere with an available bed. So then it was supposed to happen today once somewhere had been found, but by the time Social Services got their act together, it was too late for the home to get organised. So now it will be tomorrow, apparently. So she is still in the original hospital that was so determined to discharge her on Tuesday afternoon. She is allegedly ‘fine’.

You couldn’t make it up.
 

asriela

Registered User
Oct 17, 2021
26
0
This is shocking and so, so upsetting for you.
I would get in touch with my MP and also complain to the NHS Trust.
 

Scarlet Lady

Registered User
Apr 6, 2021
139
0
Hi, all. Further update: my aunt has been in the care home for two weeks. I’ve been able to visit her twice because visitor booking slots are like gold dust, apparently. She seems to have settled reasonably well, in that she is not overly agitated. Very hard to find out what exactly is going on as everyone is far too busy to tell me anything. This is even worse than the hospital.
Her legs have not stopped leaking , despite an increase in medication. They are now heavily bandaged at all times. She can’t get socks or slippers on at all. Her poor toes look dreadful. She seems to be in discomfort although the care staff are saying brightly, “Oh, she’s fine!”. She also has a massive bruise on her forehead, I’m assuming indicative of a collision with a wardrobe door or bathroom cabinet. Not surprising in a room with which she’s unfamiliar. Not blaming the care home at all, but disappointed that no one thought to mention it.
All the visitor spots before Christmas have now been taken up so I can’t see her until 28 Dec. It’s not clear if she will be bothered about this, as on the previous visits, she’s seemed happy to see me, but clearly doesn’t know who I am and promptly goes to sleep.
Today was their Christmas party, apparently with entertainment provided, but they couldn’t persuade her to join in. The floor manager somewhat reluctantly admitted that she’d refused to leave her room for days.
I haven’t yet been contacted by a Community Social Worker as promised, so have no idea what’s going to happen at the end of the month when the COVID funding runs out and the assessment has to be done.
My initial thoughts were that a home was now where she needed to be. Now I’m changing my mind. This is the most expensive care home in the borough and it’s clear that if she stays, she will be paying for care and facilities she can no longer make use of. My feeling right now is that I want to take her home with an increased care package which hopefully will meet her needs. But because nobody will be upfront and honest with me, it’s hard to work out what those needs are. I do not want to be ambushed on Jan2 with other peoples decisions.
Sorry to rant on! It’s that time of year, I think. We’ve all had enough.
 

canary

Registered User
Feb 25, 2014
16,776
0
South coast
I would check out other homes in your area @Scarlet Lady
Not all homes are the same and the most expensive ones are not always the best. Quite often they spend their budget on things that look good in the brochure and will appeal to the relatives, but are very seldom actually needed (or used) by the person with dementia. Cheaper home may not look so posh and may not have the facilities, but the care and expertise of the staff is often better.
 

Scarlet Lady

Registered User
Apr 6, 2021
139
0
Thanks, @canary . I have been investigating alternatives for a while, but part of the reason why she’s actually in the home she’s in is because it was the only one with a bed in the area that could take her. I do know of more suitable and affordable places, but they have no vacancies. They may have rooms, but insufficient staff at the moment. We seem to be caught between a rock and a hard place. I’m trying to take it one day at a time and not pre-empt the outcome, but it’s difficult. Thanks for your support.
 

Members online

Forum statistics

Threads
122,422
Messages
1,793,463
Members
73,405
Latest member
Jane Elizabeth Lewis